A Real-Life Action toward the End of HIV Pandemic: Surveillance of Mother-to-Child HIV Transmission in a Center from Southeast Romania

Preventing mother-to-child HIV transmission is a strategy to eliminate new infections to move toward a world free of HIV/AIDS. The aim of this study is to assess the effectiveness of the perinatal infection prevention program in a single center from southeast Romania. Newborns of HIV-positive mothers from 2005 to 2020 were followed-up until the age of two in a retrospective study. The transmission rate from HIV-positive mothers to living children was zero, but neonatal mortality, preterm birth and birth defects were still high. The peculiarity of our study is the high proportion of mothers with a nosocomial pattern of HIV transmission. Intensifying the efforts for accurate implementing the interventions for the prevention of mother-to-child HIV transmission, a long time follow-up for HIV-exposed uninfected children and new research on related HIV pregnancies are necessary to reach the objective of a new generation free of HIV

Clinical and paraclinical aspects in patients with hypertension associated with gastroesophageal reflux disease

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Studiile efectuate descriu combinația boala de reflux gastroesofagian (BRGE) și hipertensiunea arterială (HTA). Acestea deseori sunt asociate, frecvența fiind între 11,6 - 50%, care la moment reprezintă una din problemele medicinei contemporane. Scopul lucrării. A evidenția aspectele clinice și paraclinice la pacienții cu HTA asociată cu BRGE. Material și metode. Cercetarea se bazează pe surse bibliografice, care au fost analizate folosind PubMed, NCIB, Medscape, Mendeley publicate în anii 2021-2023 și pe studiul observațional analitic a datelor clinice și paraclinice a 200 de pacienți din Clinica Medicină Internă-Semiologie pentru anii 2018-2023. Rezultate. HTA și BRGE au următoarele interrelații patogenetice comune: modificări ischemice, inflamatorii și hemodinamice. Asocierea bolilor, clinic, se manifestă prin prezența simptomelor: pirozis (100%), regurgitări (45%), tuse (43%), palpitații (15%), valori crescute ale TA >140/80 mmHg (100%), dureri restrosternale (51%) și dispnee nocturnă (8%). Paraclinic asocierea HTA și BRGE s-a manifestat prin valori maximale ale factorilor proinflamatori IL-1 - 8,6 Pg/ml, IL-6 - 8,4 Pg/ml, PCR - 60,4 mg/L și metaboliții NO - 97,35 mmol/l. Analiza profilului lipidic la pacienții cu HTA combinată cu BRGE determină valori mărite a trigliceridelor, colesterolului și lipoproteinelor cu densitate mică. Prezența asocierii HTA și BRGE reprezintă maladii cu impact global pronunțat, una fiind factor de risc pentru cealaltă. Concluzii. Simptoamele clinice predominante sunt pirozisul și valori elevate ale TA prezente la 100% pacienți. Sindromul inflamator este prezent în majoritatea cazurilor, frecvent exprimat prin PCR și metaboliții NO. La etapa actuală a apărut necesitatea de a detalia mecanismele de dezvoltare și evoluție a HTA și BRGE, pentru a elabora o conduită de diagnostic și tratament la această categorie de pacienți.Introduction. The performed studies describe the combination of gastroesophageal reflux disease (GERD) and high blood pressure (AH). Both are often associated, the frequency being between 11.6 - 50%, which currently represents a problem of contemporary medicine. The purpose of the work. To highlight the clinical and paraclinical aspects in patients with hypertension associated with GERD. Material and methods. The research is based on bibliographic sources, which were analyzed using PubMed, NCIB, Medscape, Mendeley published in the years 2021-2023 and on the analytical observational study of the clinical and paraclinical data of 200 patients from the Internal Medicine-Semiology Clinic, period 2018-2023. Results. AH and GERD have the following common pathogenetic interrelationships: ischemic, inflammatory, and hemodynamic changes. The association of diseases, clinically, is manifested by the presence of symptom: heartburn (100%), regurgitation (45%), cough (43%), palpitations (15%), increased BP values >140/80 mmHg (100%), restrosternal pain (51%) and nocturnal dyspnea (8%). Paraclinical HTA and GERD have in common the elevation of the systemic proinflammatory factors IL-1 – 8.6 Pg/ml, IL-6 – 8.4 Pg/ml, PCR – 60.4 mg/L and NO metabolites – 97.35 mmol/l. Analysis of the lipid profile in patients with AH combined with GERD determines increased values of triglycerides, cholesterol and low-density lipoproteins. The presence of the association of AH and GERD represent diseases with a pronounced global impact, one being a risk factor for the other. Conclusions. The predominant clinical symptoms are heartburn and elevated BP values present in 100% patients. Inflammatory syndrome is present in most cases, frequently expressed by PCR and NO metabolites. At the current stage, the need has arisen to detail the mechanisms of development and evolution of AH and GERD, in order to develop a diagnostic and treatment approach for this category of patients

Variations in Biochemical Values under Stress in Children with SARS-CoV-2 Infection

In the case of SARS-CoV-2 infection, children seem to be less affected than adults, but data regarding epidemiologic characteristics and biochemical values are poor and essentially based on limited case series. The aim of our study is to highlight the predictive value of some biochemical markers at hospitalization, for the correct classification of the patient in the form of disease. Methods: We performed an analytical retrospective study on 82 pediatric patients diagnosed with COVID-19 in the emergency department, with moderate or severe form of disease, and treated in our tertiary hospital. We analyzed the epidemiologic characteristics, symptomatology and biochemical values and compare the data according to the form of disease. Results: The mean age at admission was 4.5 years (median 1 year) and the masculine/feminine ratio was 1.5. Comparing the data between the two groups of patients (42 severe/40 moderate), we observed that the severe form presented with a lower pH at admission (p = 0.02), hyperglycemia (p = 0.01), increased values of transaminases (p = 0.01 and 0.02) and hypoproteinemia (p = 0.01). Also, the severe form was statistically significantly associated with comorbidities, acute respiratory distress, rising of the inflammatory markers during hospitalization. Hyperlactatemia (Lactate > 1.5 mmol/L) was significantly associated with the age under one year (p < 0.001). Mortality rate was 9.75% and the median age at death was 3 months. Univariate logistic regression model shows that the presence of anemia increased the probability of death 88 times, comorbidities 23.3 times and ketoacidosis 16.4 times. Conclusions: Metabolic acidosis, hyperlactatemia, hyperglycemia, modified hepatic values and hypoproteinemia are biochemical markers associated with the severe form of disease in SARS-CoV-2 infection in children. Presence of anemia, comorbidities and ketoacidosis are important risk factors for death of pediatric patients with SARS-CoV-2 infection

THE TERATOGENIC EFFECTS OF ORAL CONTRACEPTIVES ASSOCIATED WITH MAXILLOFACIAL ANOMALIES

It is important to note that any changes in the treatments or medicines you use should be forwarded to your dentist during regular visits. Certain medications may interact with dental health in an unexpected way, so it is good to inform your dentist about all aspects of your health or changes. Nd: YAG laser (neodymium-yag) can be used in gingival hyperplasia therapy to treat and reduce excessive growth of gingival tissue. It is important to mention that achieving the success of Nd: YAG laser treatment may vary depending on the individual case and the medical qualifications dentist performing the procedure. Before deciding on any therapy, it is recommended to talk to your dentist for information on treatment options, benefits, and risks

POSSIBLE BY ORAL REHABILITATION OF GRAVIDE IN THE FIRST TRIESTER OF TASK

The beginning of a pregnancy brings with it oral changes in a woman’s body and can also have an impact on health. The first three months of pregnancy are critical, and proper oral rehabilitation during this period can help maintain the health of teeth and gums for both mother and fetal development. This article explores tips and precautions for oral rehabilitation in the first three months of pregnancy. During the first three months of pregnancy ( first quarter ), oral hygiene is particularly important, as hormonal fluctuations can increase susceptibility to dental and gingival problems. Anesthesia in dentistry in the first 3 months of pregnancy is a sensitive and complex subject. In general, you try to avoid exposure to chemicals and drugs in this activity, especially in the first 3 months, which are considered critical for embryonic development. However, there are situations where anesthesia may be needed to treat severe pain or to perform essential dental procedures

Hyperglycosylated-hCG: Its Role in Trophoblast Invasion and Intrauterine Growth Restriction

Human chorionic gonadotropin (hCG) is produced by the placenta and its roles have been studied for over a century, being the first known pregnancy-related protein. Although its main role is to stimulate the production of progesterone by corpus luteal cells, hCG does not represent just one biologically active molecule, but a group of at least five variants, produced by different cells and each with different functions. The hyperglycosylated variant of hCG (H-hCG) plays a key role in trophoblast invasion, placental development and fetal growth. During trophoblast invasion, H-hCG promotes extravillous cytotrophoblast cells to infiltrate the decidua, and also to colonize and remodel the spiral arteries in to low resistance, larger-diameter vessels. As fetal growth is heavily reliant on nutrient availability, impaired trophoblast invasion and remodeling of the uterine arteries, leads to a defective perfusion of the placenta and fetal growth restriction. Understanding the function of H-hCG in the evolution of the placenta might unveil new ways to manage and treat fetal growth restriction

Impact of Exogenous Factors and Anesthetic Risk in Premature Birth during the Pandemic Period

Background: Premature birth remains a public health problem worldwide, involving a broader context and a multidisciplinary team aimed at combating this phenomenon as much as possible. The consumption of addictive substances by women who are pregnant can occur in different social contexts and at different stages of their lives, which modulate its extent. Obstetricians and anesthetists should consider the anesthetic maternal risks that may arise due to these addictive behaviors. The maternal anesthetic risk is higher in women who are pregnant with a medium-level of education, imbalanced nutrition, stress associated with physical or mental activity, affected sleep hygiene, and failed marriages. Objectives: The objectives of the study refer to analyzing the impact of exogenous factors and the anesthetic risk on premature birth for women who were pregnant during the pandemic period and in women who were pregnant without COVID-19 infection. The authors studied a significant sample of 3588 women who were pregnant without COVID-19 infection, among whom 3291 gave birth at term and 297 gave birth prematurely. Methods: The methods analyzed consist of studying the specialized literature regarding the impact of exogenous factors and parturient’s anesthetic risk on premature birth and identifying the regional risk profile of women who are pregnant in the southeast region of Romania compared to that identified in the specialized literature. In the analytical methods, we used a linear regression to study the incidence of exogenous risk factors on anesthetic risk in women who were pregnant with premature births compared to those with full-term births. Results: The results confirm the significant impact of exogenous factors on anesthetic risk and the significant impact of anesthetic risk on premature births. The novelty of the study lies in highlighting the modification of the regional exogenous risk profile during the pandemic period in southeast Romania due to unfavorable socio-economic causes and the translation of grade I and II prematurity events to higher frequencies with an increased level of maternal anesthetic risk. Conclusions: The study findings show that the anesthetic risk is maximized in parturients with a middle school education. Additionally, the anesthetic risk of patients who are pregnant increases with the intensification of smoking adherence and its maintenance throughout the pregnancy at the same intensity. Our study aims to provide a basis for the diversification and development of community intervention programs in the post-COVID-19 era, considering the reshaping of social models and the repositioning of social principles and values. Obstetricians and anesthetists must know and promote family values to harmonize the lives of family members and provide a better life for the mother and child

INNOVATIVE TREATMENT TECHNIQUES IN POLYCYSTIC OVARY SYNDROME (PCOS)

Polycystic ovary syndrome (PCOS) is a common condition among women in the fertile period and can have a wide range of symptoms including menstrual disorders, infertility, and, excessive hair growth and metabolic problems. PCOS treatment may vary depending on individual symptoms and patient goals, some of the emerging technologies and innovative approaches that have been investigated in the context of PCOS treatment are: laser therapy for ovarian cysts (HIFU), focused high-intensity ultrasound therapy, gene therapy , stem cell treatment , nutrigenomics and personalized diet , etc , artificial intelligence (AI) interventions. Each technique brings with it promises and challenges, and their implementation in clinical practice requires extensive clinical studies and attention to detail. It is essential to keep the balance between innovation and safety in order to ensure real benefits for patients. Despite the early stage of much research, these innovative approaches pave the way for more efficient and personalized PCOS management

An Experimental and Virtual Approach to Hip Revision Prostheses

(1) Introduction: The changes in the joint morphology inevitably lead to prosthesis, but the hip pathology is complex. The hip arthroplasty is a therapeutic solution and can be caused, most frequently, by primary and secondary coxarthrosis due to or followed by traumatic conditions. The main aim of this study was to find the method of revision hip prosthesis that preserves as much bone material as possible and has sufficiently good mechanical strength. (2) Materials and Methods: In this study, in a first step, the two revision prostheses were performed on bone components taken from an animal (cow), and then, they were tested on a mechanical testing machine until the prostheses physically failed, and the force causing their failure was determined. (3) Results: These prostheses were then modelled in a virtual environment and tested using the finite element method (FEM) in order to determine their behaviour under loading from normal human gait. Displacement, strain, and stress maps were obtained. (4) Discussion: Discussions on hip revision prostheses, method, and theory analysis are presented at the end of the paper. (5) Conclusions: Important conclusions are drawn based on comparative analyses. The main conclusion shows that the both orthopaedic prostheses provide a very good resistance